Breast Augmentation-Assessing the Patient Breast Augmentation-Assessing the Patient

Bhupesh Vasisht, MD, FACSSouth Shore Plastic Surgery & Center

for Aesthetic LaserVoorhees, NJ

Bhupesh Vasisht, MD, FACSSouth Shore Plastic Surgery & Center

for Aesthetic LaserVoorhees, NJ

Learning ObjectivesLearning Objectives

�Effectively examine patient seeking breast augmentation

�Make precise preoperative decisions

�Identify problem cases before surgery

�Effectively examine patient seeking breast augmentation

�Make precise preoperative decisions

�Identify problem cases before surgery

The Four D’s Principle of Vasisht

The Four D’s Principle of Vasisht

�Diagnosis- Examine the breast well

�Decisions- Know all the options before and after the augmentation

�Dissection- Execution of the procedure

�Disaster Prevention- Avoid them!

�Diagnosis- Examine the breast well

�Decisions- Know all the options before and after the augmentation

�Dissection- Execution of the procedure

�Disaster Prevention- Avoid them!

Homerun Every time?Homerun Every time?

HistoryHistory

�Get a good history…!

�LISTEN TO THE PATIENT

�LISTEN TO THE PATIENT

�LISTEN TO THE PATIENT

�Get a good history…!

�LISTEN TO THE PATIENT

�LISTEN TO THE PATIENT

�LISTEN TO THE PATIENT

Physical Exam- DiagnosisPhysical Exam- Diagnosis

� SN to Nipple

� Nipple to IMF

� IMF location and appearance

� Base Width

� Tissue thickness/stretch-pinch test

� Pre Op SYMMETRY

� SN to Nipple

� Nipple to IMF

� IMF location and appearance

� Base Width

� Tissue thickness/stretch-pinch test

� Pre Op SYMMETRY DimensionsEnvelopeParynchyma

Key FactorsKey Factors

�Tissue thickness

�Symmetry -glandular or nonglandular

�Chest wall issues

�Ptosis

�Match patient desire to what is possible with their anatomy

�Tissue thickness

�Symmetry -glandular or nonglandular

�Chest wall issues

�Ptosis

�Match patient desire to what is possible with their anatomy